Application of the Microdebrider for the Treatment of Laryngeal Granuloma

Abstract

Laryngeal granuloma is intractable and tends to recur. Recently, the relationship between laryngeal granuloma and gastro-esophageal reflux disease (GERD) or laryngo-pharyngeal reflux disease (LPRD) has been scrutinized. In the case of LPRD, it is widely acknowledged that the first choice of the treatment for laryngeal granuloma is antireflux medicines; however, there are some patients who are not cured by this conventional treatment. In this study, we investigated the benefits of powered instruments, i.e. Microdebrider to treat this disease. Fifty-six cases of the treatment were retrospectively analyzed. The overall cure rate was such as; 26% in patients treated with cold instruments, 53% in patients treated with laser vaporization, 75% in patients administered proton pump inhibitors, and 100% in patients treated with Microdebrider. On the other hand, we analyzed the effect of Microdebrider in patients with recurrent granuloma after initial treatment. Five recurrent cases after treatment with other methods were performed surgery with the use of Microdebrider. The use of the Microdebrider has shown no recurrence to date. These findings indicate that the Microdebrider is superior to conventional surgical procedures, although administration of antireflux medicine is the first choice.